Three Rivers Community Hospital and its strategic partners, operating in a geographically vast and rural environment, will implement health information technologies that are specifically related to medication administration and management, and will assess the extent to which these technologies contribute to measurable and sustainable improvements in patient safety and quality of care. Results from this implementation study will inform the Agency for Healthcare Research and Quality, providers, patients, payers, policymakers, and the general public about how health information technology can be successfully implemented in rural settings and lead to safer and better health for all Americans. In specific, the implementation project, which features a closed computerized loop, will study: (a) improvements in safety, timeliness, and effectiveness of medication management and administration; (b) improvements to the organizational culture of efficiency and cost-effectiveness; and, (c) increases in the alignment of medication-administration practices with the philosophy of patient-centered care. The implementation project will examine these improvements while overcoming implementation resistance through the application of a "bottom-up" workflow redesign model that strategically involves stakeholders early and meaningfully in the process, while superimposing planned and actual implementation on an adopted model of human resources management. By attaining this latter characteristic, the implementation project will blend "high tech" with "high touch." [unreadable] [unreadable]